ABSTRACT
BACKGROUND: Hospital nurse practitioner (NP) turnover is costly and complex. PURPOSE: Provide a pre-COVID-19 pandemic baseline of hospital NP turnover. METHODS: A secondary analysis of NSSRN18 data on 6,558 (67,863 weighted) NPs employed in hospitals on 12/31/2017. We describe rates of turnover, intention to leave, and reasons for leaving or staying. Using multivariate logistic regression, we examine the association between individual and organizational characteristics and turnover. Survey weights and jackknife standard errors were applied to analyses. DISCUSSION: Approximately 10% of NPs left their job the following year, and 53% of NPs that remained considered leaving at some point. The top reasons cited for leaving or staying were largely organizational factors. Regression analysis revealed not practicing to one's fullest scope, lower income, lack team-based care, and non-white race were associated with an increased likelihood to leave. CONCLUSION: We find several modifiable factors associated with hospital NP turnover that can be used to tailor recruitment and retention strategies.
ABSTRACT
ABSTRACT: The Advanced Practice Registered Nurse (APRN) Consensus Model was developed in 2008 by the APRN Consensus Work Group and the National Council of State Boards of Nursing APRN Advisory Committee. This model aims to improve access to APRN care through standardization of licensure, accreditation, certification, and education and has been adopted by many organizations throughout the United States. However, the Consensus Model is not a legislative document, and there is variation in adoption and implementation throughout states and organizations. Since the Consensus Model was developed, little is known about how this change has affected hiring practices for nurse practitioners (NPs) and physician assistants (PAs). There are concerns that the model may place burdensome hiring constraints on NP hires, which could inadvertently lead to preferential hiring of PAs over NPs. We evaluated whether there was a significant association between the proportion of NPs versus PAs hired after the implementation of the APRN Consensus Model in 2017 in a large not-for-profit health system in North Carolina. Our study revealed no association between implementation of hiring practices to align with the APRN Consensus Model and preferential hiring of PAs over NPs.
